The vulnerable stomach in babies born with pure oesophageal atresia

Nine babies with pure oesophageal atresia were treated in our institution i n the years 1979-1996. All received a feeding gastrostomy as their initial operation. After initiation of gastrostomy feeds seven (78%) developed gast ric complications, including two posterior gastric perforations tone fatal) . We propose that the high complication rate is due to a small, abnormal st omach that is vulnerable to damage by operative trauma and the effects of h andling large volumes of feed. We hypothesise that the stomach is abnormal because it has not been exposed to the maturing effects of amniotic fluid i n utero. Feeds should be introduced very cautiously to these babies and bui lt up very slowly.